Frontal sinus pattern analysis for human identification using non-contrast computed tomography images: A Sri Lankan experience

Objective: Morphometry of frontal sinuses has been studied extensively in many countries. However, these findings cannot be generalized due to genetic and environmental factors affecting the skeletal structure. The main aim of this study was to morphometrically analyze the frontal sinuses in patients who underwent non-contrast computed tomography (NCCT) skull imaging at Teaching Hospital Peradeniya and to assess its association with age and sex. Methods: This retrospective study included 300 NCCT skull images obtained by a multi-slice computed tomography(MSCT) scanner at the Teaching Hospital Peradeniya. This age- and sex-matched sample was selected using consecutive sampling and consists of seven age groups (20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80–89). Right and left frontal sinus values (length, height, width of each sinus, and total width) were measured using the RadiaAnt DICOM Viewer 2020.2.3 software, and age and sex were obtained from the CT images. The association among the variables was analyzed using the t-test and binary logistic regression model. Results: In our study sample, 59% (n = 177) were male and the mean age was 57.94 years. The means of left side sinus values were larger than right sinus values, which was statistically significant. A statistically significant association was seen between frontal sinus parameters and sex; those of males were higher than that of females. No significant association between the sinus size and age was observed. Conclusion: Morphometric analysis of frontal sinuses using NCCT images is useful for the sex differentiation of unknown bodies for medico-legal purposes. Furthermore, the mean sinus values specific to the current study population will also be helpful in ethnic differentiation.

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